It’s all about hope.
I’m out of hospital. I have a lot going on in my life right now, so I haven’t been writing. I may start again when I have things to say, and the space to do it. There is a lot of psychology/mental health in my life as it is – with university, work and volunteering – and I need to spend my spare time focusing on other things for now.
I’ve been away for work since Monday. I work on an island, at a residential camp. A large proportion of the kids we get are from disadvantaged backgrounds – whether that means they’re in out of home care; experiencing behavioural, learning or emotional disorders; in community support programs; or a whole range of other circumstances. It’s a very stressful job which comes with huge responsibilities, reporting back to the Department of Communities. I’m absolutely exhausted at the moment – working sixteen hour days doesn’t agree with me, but I love my job. It rained torrentially from Monday to Thursday, but today was beautiful. Here’s some photos I took this morning.
I love this island. It soothes my soul. All week I’ve been musing, breathing in the salt water and rain, navigating the bush covering the island by moonlight. I’ve been having a hard time relating to people in my life lately. Getting easily frustrated and upset at their actions, finding it difficult to bite my tongue. I know how it is to be disempowered – I spent a long time there. But I’m finding it very hard recently to remember that where people are in their journeys is only a reflection on them. I feel like a horrible person – I should be more sympathetic, I should be kinder, I shouldn’t get upset over the things that I do.
I need to be kinder to myself. I need to reassess what (and who) I can and can’t have in my life if I’m doing what is best for me. I chronically push myself too far, overcommit and give too much of myself to others. I need to remember to look after myself as well, and not emotionally invest so much in others wellbeing.
On a different note, I’m so incredibly lucky to work in such a beautiful place.
I’ve been neglecting this space somewhat. I’m drowning in university work which I don’t seem to be able to do. I have all my references, I’ve written out structured plans for my reports and essays, but somehow there is a block when I actually attempt to do this work. I lay out my books, articles, pencilcase and laptop, open a word document… and then nothing. I’ve spent hours sitting staring at the blank screen, knowing exactly what I need to do but not being able to string the words together to form a logical argument.
It makes me feel so lazy. It’s so hard to explain the complete absence of motivation that comes with depression. That I love what I study – I love learning, I love doing well academically, I love piecing research together and weaving ideas into a coherent response. But recently my mind is blank. I close my eyes to try to focus and there is nothing there – a faint buzzing and grey static, punctuated only by intense ideation, primal screaming and violent imagery.
I’m going to need to apply for extensions for these assignments which makes me feel so pathetic. I got through last year without using any extensions, and that made me feel good about myself. I don’t like having to ask for special consideration. I don’t want to be that person. It embarrasses me, and it makes me disappointed in myself. Surely if I’ve managed before I can manage again? I need to keep reminding myself that there is a reason this is happening. I need to get back on my medication. I need some more support so that every inch of energy is not expended on keeping myself safe.
I’m going away for work tomorrow, I’ll be without internet until Friday. I’m not sure how I will cope with my headspace – but I keep reminding myself that I have been away working in far worse states than this, and I got through that. This – medical complications, ideation and strange sensory side effects – this is small game. I can do this. Thankfully I have an amazing job – on an isolated island surrounded by bush. When I’ve been unwell while working in the past, I spend the nights wandering the beach and navigating the island by moonlight. It’s a beautiful place.
The week that I return I have two exams, and when they are done I will be going into hospital. It’s a complicated situation that I don’t have the energy or cognitive function to explain right now – but I’ve been teetering on the edge for a long time, ignoring the signs. I’ve been lucky to have managed to stay out (not including schedules and emergency presentations) this long since returning home, and it’s time I swallowed my pride and accepted more help. Noone is going to change this for me. I have to make these decisions myself, and accept that things aren’t okay. When I can think more clearly I will explain further. For now, look after yourselves, and look after each other.
The last week, there has been a lot of talk surrounding eating disorders and treatment in the blogs that I follow. Last week, when I took my letter to register with disability services at university for the year, my advisor read through the listed diagnoses. “Depression, insomnia, OCD, PTSD, EDNOS – how long have you had an eating disorder for?”. It’s a difficult question. Immediately I spit out “oh, I don’t have an eating disorder anymore. It must just still be listed on my file”. I don’t think of myself as having an eating disorder – god no. But taking a step back – thinking about my behaviours in terms of symptoms on a diagnostic check list… I suppose I do fill the criterion. It’s just so much easier to not think about.
Eating disorders are insidious. Despite having been weight restored for almost four years, I still sometimes feel the tantalising pull of my eating disorder. It’s not something that I feel is important – at least not at this point in time – there are bigger struggles to be fought.
It does scare me, however, how ingrained into my life this has become. There’s nothing strange or shocking to me about self induced vomiting, ingesting poisons to aid purging, going days without eating. My electrolytes are regularly tested as abnormal, my heart skips and starts and I shrug it off as nothing. Over the years I’ve watched perhaps fifteen – twenty friends that I’ve made, in and out of hospital, die to these diseases. The first few were devastating – and the lives lost are still tragic, of course, but it doesn’t terrify me to hear that another one of us has fallen, like it once did (like it should).
One in five is a huge mortality rate for any illness – and is shocking for a preventable, mental illness. The Butterfly Foundation also reports that those with anorexia nervosa are 32x more likely to suicide than their healthy counterparts. It’s a terrifying thought. With such devastating morbidity (almost one in four young women) and mortality rates, one would think that there would be effective national and international preventative campaigns, early intervention treatment, and widespread intensive specialised treatment for severe eating disorders.
But there’s not. I’m lucky enough to have private health insurance and access to eating disorder units in private hospitals – but not everyone is. I know without a doubt that without the hospitalisations and interventions I was exposed to from ages 13-19, I would be dead. Many times I showed up at the door of the emergency department of my local hospital, chest pains, aching head and shaking like a leaf – and they would give me a few hours on fluids and potassium, then discharge me. Without ongoing care in the private sector – I don’t doubt for a second that I would have been one of those girls who dies suddenly – her heart stopping in her sleep.
Recently, one of my friends was admitted to a public hospital over a weekend and discharged on Monday on the grounds of not being sick enough – despite plummeting blood sugar and fainting on her way out of the unit. You can read more about her story here – but what I really want to share with you is the petition that she has created regarding eating disorder services in our state. Despite the growing prevalence of eating disorders, we have two acute inpatient beds dedicated to eating disorders, statewide. It’s simply not good enough. To get one of these beds – which are usually reserved for severe anorexia (despite it not being the only eating disorder – which is a thought for a whole other post) – being on your death bed is practically a requirement. Lives are being lost because there isn’t enough available treatment, and they don’t need to be. Please sign, and share, and talk about this.
I remember being told in one of my first hospitalisations for anorexia nervosa that out of each five people with the illness – one would die, one would recover, and three would live with an eating disorder – in whatever shape or form, for the rest of their lives. To be entirely honest I don’t see the eating disorder voice ever leaving my head – it planted itself early and it has dictated so much of my self development. I have learnt to live with it, though – I can eat relatively well and maintain my weight , coax food into my mouth despite my head’s protests against me. Yes, I know people who have fully recovered. But they are definitely the minority. But it’s a terrifying thought that I know of more people who have died as a result of their eating disorder than I do people who have fully recovered, and maintained that recovery.
It scares me that even this level of ‘recovery’ is not available to everyone. It’s taken years of intensive therapy and many hospitalisations to get me to this level of medical and psychological stability. It shouldn’t be a challenge to reach a vague semblance of recovery. Eating disorders are incredibly difficult and exhausting to fight – and those suffering shouldn’t have to fight not only for their body and their lives, but their treatment as well. An eating disorder is already living a war inside one’s head. It’s not fair, and it’s not okay. While I am absolutely aware of how lucky I am to live the life that I do in the world that I do, it scares me to think that in terms of treatment – despite how inconsistent, often useless and varied mine has been – I am one of the lucky ones.
Check out part one of this post here.
Over the last 24 hours I’ve been thinking about what my life would look like if I were where I want to be. In each area, it would look something like this:
Health (physical): exercising each day, eating three meals & snacks each day, taking iron tablets, keeping up to date with my b12 injections, having regular iron transfusions, sleeping at least 5 hours each night.
Health (mental): being motivated enough to get up each day and achieve something, be able to do what I want, when I want – without my mental health being an obstacle.
Relationships: being comfortable with others, being able to be open with friends about what is going on for me, feeling comfortable expressing (and accepting) love.
Education: attending classes, completing necessary readings and assignments, continuing into Honours and Masters in Psychology.
Employment: continuing working in the positions I’m currently in, feeling satisfied with what I am contributing to the world, earning enough money to be independent and comfortable.
Community: actively volunteering, feeling useful, feeling as though I am making a meaningful difference.
Leisure & relaxation: resuming sailing, seeing friends regularly, practicing mindfulness, baking, travelling, bushwalking.
So – that’s an indication of how things would be if they were ideal at the moment. Employment and community are pretty much the only thing I’m satisfied with at the moment. This impression is quite dissonant from how things actually are. There are quite a few things that could change within each category, but it’s not exactly realistic to attempt to entirely change my life immediately – that would just set me up to fail. So I’m going to make a couple of small, SMART goals for each area that I feel isn’t where I want it to be.
SMART goals are something I learnt about during some hospitalisation or another – they’re a framework for setting goals which we are more likely to achieve than grandiose, unrealistic ambitions. You can read more about SMART goals here, but basically they are goals which are specific, measurable, attainable, realistic and timely.
– write a meal plan incorporating regular meals for the next two weeks, and do my best to follow it.
– buy syringes & do b12 injection for this fortnight.
– for for at least 4x 1hour walks each week, for the next two weeks.
– journal daily to get an idea of what I’m feeling and be better able to identify patterns and triggers.
– attend psychologist appointment next week.
– contact (text/call/facebook/skype) at least one friend a day for the next two weeks, telling them something I love about them.
– email a friend and explain that I have been struggling.
– write a realistic daily to do list in order to catch up on lectures and readings that I have missed.
– organise notes to study for an exam I have next Wednesday.
Leisure & relaxation:
– go for a bushwalk this weekend.
– resume crocheting the blanket I abandoned.
So, that’s a start. Steps to getting myself back on track.I’m going to print off these goals and stick them on my mirror, along with a daily checklist to tick off whether I’ve accomplished what I intend to. This will be difficult – at the moment it’s an effort to get out of bed, brush my teeth or open my mouth to speak to anyone and it feels like I’m trudging through knee deep mud – but I’m not going to get anywhere by staying still. I’ll check back in after a week to see how I’m going with these goals, again in a fortnight, and then perhaps reassess and make some more goals.